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• W2223337248 abstract "Severe aortic stenosis (AS) is considered a condition at high risk for cardiac complications during noncardiac surgery. This conclusion is mostly based on reports published more than a decade ago, which included mixed cohorts of patients with AS who were symptomatic, had left ventricular dysfunction and concomitant other valvular disease (e.g., mitral regurgitation). Granted, although symptomatic patients with severe AS are at higher perioperative risk for noncardiac surgery, more controversial is the asymptomatic patient. To this regard, the current European Society of Cardiology guidelines on valvular heart disease state that low-intermediate risk elective noncardiac surgery should be considered in asymptomatic patients with severe AS (level of evidence C). 1 Kristensen S.D. Knuuti J. Saraste A. Anker S. Botker H.E. De Hert S. Ford I. Gonzalez-Juanatey J.R. Gorenek B. Heyndrickx G.R. Hoeft A. Huber K. Iung B. Kjeldsen K.P. Longrois D. Luescher T.F. Pierard L. Pocock S. Price S. Roffi M. Sirnes P.A. Sousa-Uva M. Voudris V. Funck-Brentano C. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management the Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Euro H Journ. 2014; 35: 2383-2431 Crossref PubMed Scopus (141) Google Scholar Notwithstanding, many of these patients still undergo aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), with an inherent AVR/TAVI perioperative risk that is twofold to fourfold higher than that reported for noncardiac intervention in the presence of AS. 2 Goodney P.P. O'Connor G.T. Wennberg D.E. Birkmeyer J.D. Do hospitals with low mortality rates in coronary artery bypass also perform well in valve replacement?. Ann Thor Surg. 2003; 76: 1131-1136 Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar , 3 Leon M.B. Smith C.R. Mack M. Miller D.C. Moses J.W. Svensson L.G. Tuzcu E.M. Webb J.G. Fontana G.P. Makkar R.R. Brown D.L. Block P.C. Guyton R.A. Pichard A.D. Bavaria J.E. Herrmann H.C. Douglas P.S. Petersen J.L. Akin J.J. Anderson W.N. Wang D. Pocock S. Investigators P.T. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. NEJM. 2010; 363: 1597-1607 Crossref PubMed Scopus (5333) Google Scholar , 4 Nishimura R.A. Otto C.M. Bonow R.O. Carabello B.A. Erwin 3rd, J.P. Guyton R.A. O'Gara P.T. Ruiz C.E. Skubas N.J. Sorajja P. Sundt 3rd, T.M. Thomas J.D. American College of Cardiology/American Heart Association Task Force on Practice Guidelines2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. JACC. 2014; 63: e57-185 Abstract Full Text Full Text PDF Scopus (2052) Google Scholar" @default.
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• W2223337248 date "2016-02-01" @default.
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• W2223337248 title "Asymptomatic Severe Aortic Stenosis and Noncardiac Surgery" @default.
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